Returning home for HIV & AIDS treatment, an Ethiopian woman finds much more

In 1992, Neima Mohammed left Ethiopia for Djibouti with hopes of building a better life for her family. Living at a refugee camp 10 years later, the family made plans to travel to Australia and applied for a visa, which required an HIV & AIDS test. While her husband and two sons tested negative, Neima tested positive. Neima’s husband immediately left her, and before long, she became ill and bed-ridden.

This story might have ended with Neima’s fateful decline in health. Fortunately, thanks to friends back home, Neima learned Ethiopia was embarking on efforts to provide free antiretroviral treatment to thousands of people living with the disease. Without hesitation, Neima returned home. She didn’t expect to survive, but simply hoped to find comfort through treatment in the mosaic city of Dire Dawa. Dire Dawa – which neighbors the city of Harar where Niema was born and raised – is an industrial center for eastern Ethiopia and a business corridor to Djibouti and Somaliland.

Back in Dire Dawa, Neima’s condition worsened as she waited to become clinically eligible for treatment. She was critically ill when admitted to Dil Chora Hospital, but CD4 machines to test her white blood cell count were only available at a few facilities in Addis Ababa – 510 kilometers from Dire Dawa. It would take a minimum of three to four months to get her results. Her physician decided to put her on treatment without waiting for the test.

Much has changed for patients since Neima was first treated. CD4 machines are now operational in more than 150 health facilities nationwide, and reagents for testing are regularly refilled. Test results can be ready in as little as 30 minutes. The national HIV & AIDS Resource Center estimates that there has been a ten-fold increase in the number of people tested for HIV each year since 2005. Currently, 36 percent of women and 38 percent of men have been tested and received their test results.

The Supply Chain Management System (SCMS), a PEPFAR-funded program and administered by USAID, works with Ethiopia’s Pharmaceutical Fund and Supply Agency (PFSA), nine regional health bureaus and more than 1,717 health facilities to improve access to HIV & AIDS treatment. SCMS procures and supports the Pharmaceutical Fund and Supply Agency (PFSA) in distributing antiretroviral medicines, other essential drugs, test kits, laboratory commodities, food-by-prescription and health system strengthening commodities, such as warehouse equipment, vehicles, generators and cold rooms. SCMS has also trained more than 2,400 health professionals and pharmaceutical logistic workers from health facilities on logistics management information systems, forecasting and quantification, warehouse operations and management. This training is instrumental in helping ensure an uninterrupted supply of HIV & AIDS commodities for health facilities, like Dil Chora Hospital, that provide life-saving services to patients like Neima.

Neima is now newly married to a man who also lives with HIV & AIDS. Thanks to the medicine she received at Dil Chora Hospital, she was able to give birth to a healthy boy and prevent the transmission of HIV to her son during labor. During and after her pregnancy, Neima found nourishment with ready-to-use therapeutic food through the food-by-prescription program run by Save the Children US and World Food Program and supported by PFSA and SCMS.

Currently there are 280 health facilities providing food-by-prescription services in Ethiopia. More than 81,000 people benefitted from the program between 2009 and 2011. Due to PFSA’s reliable distribution of commodities to treatment sites, Neima has been on uninterrupted antiretroviral treatment since 2006.

Neima now serves as a peer educator at Dil Chora Hospital. She never stops thanking the hospital for the commodities and services they make available to the thousands of Ethiopians infected with HIV & AIDS.